The American journal of managed care
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Randomized Controlled Trial
A comprehensive hospital-based intervention to reduce readmissions for chronically ill patients: a randomized controlled trial.
Medicare penalizes hospitals with 30-day readmissions above their expected rates. Hospitals have responded by implementing transitional care interventions; however, there is limited evidence to inform the development of a successful intervention. ⋯ Stand-alone community hospitals may be unable to prevent readmissions despite the use of comprehensive, evidence-based intervention components that are within their control. Better collaboration between hospitals and community-based providers is needed to ensure continuity of care for discharged patients.
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To determine whether racial disparities in process quality and outcomes of care change under hospital pay-for-performance. ⋯ Our results show no evidence of a deleterious impact of P4P in the Premier HQID on racial disparities in process quality or outcomes.
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To examine the relationship between the compensation strategies of primary care physicians (PCPs) and the quality and outcomes of care delivered to Medicare beneficiaries. ⋯ Physician compensation strategies are associated with the quality of preventive services delivered to Medicare patients, but inconsistently associated with outcomes of care. Increasing use of global payment strategies is not likely to lead to lower quality.
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A possible remedy for health disparities is for employers to promote cardiovascular health among minority employees. We sought to quantify the financial return to employers of interventions to improve minority health, and to determine whether a race- or risk-targeted strategy was better. ⋯ Targeting all high-risk employees for cardiovascular risk reduction may be a win-win-win situation for employers: improving health, decreasing costs, and reducing disparities.
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To compare treatment patterns, resource utilization, and costs to US third-party payers of stimulant-treated adolescent attentiondeficit/ hyperactivity disorder (ADHD) patients who switched to or augmented with atypical antipsychotics (AAPs; not FDA-indicated for ADHD) with those who switched to or augmented with nonantipsychotic medications. ⋯ Stimulant-treated adolescents with ADHD who switched to or augmented with AAPs had significantly greater drug augmentation, healthcare resource utilization, and costs compared with the non-antipsychotic cohort.